Safety of outpatient kidney biopsies

Scientific paper - Original scientific paper

• Author: Bojana Šimunov
• Author: Mihaela Gunjača
• Author: Branislav Čingel
• Author: Dinko Škegro
• Author: Mladen Knotek
• Author's institution: University of Zagreb; School of Medicine
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences

Abstract (english)

BACKGROUND:
Kidney biopsy is frequently performed in our centre as an outpatient procedure. The aim of this study was to evaluate the safety of biopsy in the outpatient setting. ----- METHODS:
We analysed kidney biopsies performed from March 2013 to February 2017. Seven hundred twenty-five biopsies performed in the outpatient setting were identified: There were 592 transplant and 133 native biopsies including 3 solitary kidney biopsies. All were performed under ultrasound guidance using a 16G or 18G needle, with freehand technique. In all patients with estimated glomerular filtration rate (eGFR) <30 mL/min/1.73 m2 desmopressin was administered. Patients were observed for 6h before discharge, with a complete blood count and urine test after 4 h. Major complications were haemorrhage requiring therapeutic intervention or transfusion. Minor complications were significant reduction in haemoglobin (Hb) levels (>10%), without need for transfusion or intervention and macrohaematuria. ----- RESULTS:
There were 506 (69.8%) male patients. Average age was 50.3 ± 12.7 years. Indications for native kidney biopsy included nephrotic syndrome (39.8%), nephritic syndrome (42.9%), follow-up biopsy (15.8%), and other (1.5%). There were no major complications. A decline in Hb was observed in 72% of patients. Average Hb decline was 4.2 ± 6.3 g/L. In 10.1% patients there was >10% reduction in Hb level, with no evident bleeding, including by ultrasonography. In 2.5% of patients, macrohaematuria was present. In a multivariate analysis, male gender, lower eGFR, higher pre-biopsy Hb and native kidney biopsy were predictive for Hb decline. No therapeutic interventions were required. ----- CONCLUSION:
We found that kidney biopsy performed in an outpatient setting in select patients is only rarely associated with adverse events and is a safe procedure.

• Keywords (english): Adult; Aged; Biopsy/adverse effects; Biopsy/statistics & numerical data; Female; Glomerular Filtration Rate; Hematuria/etiology; Hemoglobins/analysis; Hemoglobins/metabolism; Hemorrhage/etiology; Humans; Image-Guided Biopsy; Kidney/pathology; Kidney Diseases/diagnosis; Kidney Diseases/pathology; Kidney Transplantation; Male; Middle Aged; Outpatients; Patient Safety , Retrospective Studies; Ultrasonography, Interventional
• Language: english
• Publication type: Scientific paper - Original scientific paper
• Publication status: Published
• Peer review: Peer review
• Publication version: Accepted version
• Journal title: Nephron
• Numbering: vol. 138, no. 4, pp. 275-279
• p-ISSN: 1660-8151
• DOI: https://doi.org/10.1159/000484991
• URN:NBN: urn:nbn:hr:105:237460
• Publication: 2018
• Document URL: https://doi.org/10.1159/000484991
• Type of resource: Text
• Access conditions: Open access
• Created on: 2024-03-28 10:15:17